Just so we are clear, a high step score DOES NOT equal success

[piii]

I see a lot of posts on here about how they’ll get into medical school and all they need is a high step 1 score and they’ll be fine. A high step score DOES NOT make up for a DUI. It does not make up for being a Caribbean grad. It does not make up for bad clinical grades, poor third year evaluations, bad letters of recommendation, poor interviewing, and no leadership or perceived commitment to the field.

Many of my classmates are crushing it with low step scores because they have good evals and comments, commitment to the field etc. Hate to say it but residency success is holistic. Don’t bank on being a good test taker cause you did well on the MCAT.

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[JPmoleymole]

Ok

 

[Lawpy]

I take it the Step 1 mania got out of control. Many med students seem to think Step 1 is the last step of their careers and nothing else matters.

 

[caterwaiter]

Hate to say it but residency success is holistic.

...As it should be.

 

[LizzyM]

Just as a high MCAT is not the be-all and end-all of med admissions. A low one can shut some doors but a high one alone won't get you a seat.

 

[Engrailed]

Gosh this cycle is not even over and are we already agonizing over Step scores? Sigh.

 

[Blueprint Med School]

A Step score is no different than an MCAT score. A very sharp but shiny double-edged sword. A good score can wash away some of the sins of your academic past (nobody cared that I got a C in Bio 2 when I got a 12 on the Bio MCAT section 3 years later) but it will not make you, though a bad performance can break you and close doors.

David D, MD - USMLE and MCAT Tutor
Med School Tutors

 

[Goro]

I see a lot of posts on here about how they’ll get into medical school and all they need is a high step 1 score and they’ll be fine. A high step score DOES NOT make up for a DUI. It does not make up for being a Caribbean grad. It does not make up for bad clinical grades, poor third year evaluations, bad letters of recommendation, poor interviewing, and no leadership or perceived commitment to the field.

Many of my classmates are crushing it with low step scores because they have good evals and comments, commitment to the field etc. Hate to say it but residency success is holistic. Don’t bank on being a good test taker cause you did well on the MCAT.

Indeed. Step is just a screening tool.

 

[lm1106]

How important is personality (extroversion, sociability, etc) for letters of rec and evaluations? What if you’re decently smart and have a great work ethic but u kinda on the quieter side - is being quiet perceived negatively?

It hasn’t been an issue for me so far, I guess bc I’ve been lucky to have mentors/supervisors/professors that noticed my hard work despite the fact that I tend to keep my head down. Is it a different culture in medical school? Or does it just depend on the school/program/people you work with?

 

[ciestar]

How important is personality (extroversion, sociability, etc) for letters of rec and evaluations? What if you’re decently smart and have a great work ethic but u kinda on the quieter side - is being quiet perceived negatively?

It hasn’t been an issue for me so far, I guess bc I’ve been lucky to have mentors/supervisors/professors that noticed my hard work despite the fact that I tend to keep my head down. Is it a different culture in medical school? Or does it just depend on the school/program/people you work with?

IMO, it changes depending on what specialty you’re going for. FM it is really based on fit and whether they like you as a person. Im incredibly introverted but managed to come out of my shell for my clerkship years and i really think that helped me with the apparently wonderful LORs ive gotten

 

[deleted987519]

Don’t hug me, I’m scared

 

[efle]

How about we just give people the data and let them decide whether Step 1 Mania is happening for a reason

Tableau Public

public.tableau.com

Select some competitive specialties (e.g. derm, surgical subspecialties) and then think about whether youd rather have a 250+ versus stronger leadership, volunteering, etc. It strikes me as a no brainer

 

[Dr panda]

How about we just give people the data and let them decide whether Step 1 Mania is happening for a reason

Tableau Public

public.tableau.com

Select some competitive specialties (e.g. derm, surgical subspecialties) and then think about whether youd rather have a 250+ versus stronger leadership, volunteering, etc. It strikes me as a no brainer

Isn’t it why they want to switch step 1 score to be pass/fail?

 

[CidHighwind]

MS4 here. Residency applications are “holistic” the same way “top tier” medical school admissions are holistic. They don’t look past bad numbers (which is different than being okay with above average numbers) but they care about MORE than numbers. Numbers are still a big part of it, and anyone that says otherwise is lying.

 

[Princeton Medical Student]

Isn’t it why they want to switch step 1 score to be pass/fail?

Step 1 being pass fail would be an absolutely horrendous idea for anyone not at top schools and if it were to happen I would avoid DO like plague even if it took 3 years.

 

[Lawpy]

How about we just give people the data and let them decide whether Step 1 Mania is happening for a reason

Tableau Public

public.tableau.com

Select some competitive specialties (e.g. derm, surgical subspecialties) and then think about whether youd rather have a 250+ versus stronger leadership, volunteering, etc. It strikes me as a no brainer

But its not like Step 1 alone will guarantee getting into those specialties, especially when everyone at that level has high Steps. That's why everything else matters. The Step 1 addicts usually just focus on Step 1 and ignore everything else.

Also school name can compensate a lot for Steps.

 

[Cornfed101]

How important is personality (extroversion, sociability, etc) for letters of rec and evaluations? What if you’re decently smart and have a great work ethic but u kinda on the quieter side - is being quiet perceived negatively?

It hasn’t been an issue for me so far, I guess bc I’ve been lucky to have mentors/supervisors/professors that noticed my hard work despite the fact that I tend to keep my head down. Is it a different culture in medical school? Or does it just depend on the school/program/people you work with?

In my experience (as an introvert), I need alone time to recharge. I don’t love being in big groups all the time, but in healthcare a lot of your interactions are 1 on 1. I love small interactions like that. I’m not as talkative as other people who are more extroverted, but that’s definitely not a bad thing. I like to develop a little rapport, but I also appreciate getting to business.

I’m not a physician, but I work in a clinical setting, and I don’t think the 1 on 1 aspect is going to change dramatically, just my roles within that dynamic.

You are not looking for a group eval or LOR, you are getting an individualized eval. Keep that in mind!

 

[CidHighwind]

How important is personality (extroversion, sociability, etc) for letters of rec and evaluations? What if you’re decently smart and have a great work ethic but u kinda on the quieter side - is being quiet perceived negatively?

It hasn’t been an issue for me so far, I guess bc I’ve been lucky to have mentors/supervisors/professors that noticed my hard work despite the fact that I tend to keep my head down. Is it a different culture in medical school? Or does it just depend on the school/program/people you work with?

Depends on the specialty. Something like IM or Neurology it won’t matter. If you go into something like Ortho and aren’t a good “fit”, then it could be held against you despite a great app. People will say otherwise since that sounds really crappy, but that’s how the real world works.

I assume that’s one big reason they make EM applicants get SLOEs. Even if they’re smart on paper, if they’re weird or have a personality disorder, they can write glowingly about how well they did but then mark them down on the “where we will rank this applicant” part.

 

[Blueprint Med School]

Depends on the specialty. Something like IM or Neurology it won’t matter. If you go into something like Ortho and aren’t a good “fit”, then it could be held against you despite a great app. People will say otherwise since that sounds really crappy, but that’s how the real world works.

I assume that’s one big reason they make EM applicants get SLOEs. Even if they’re smart on paper, if they’re weird or have a personality disorder, they can write glowingly about how well they did but then mark them down on the “where we will rank this applicant” part.

SLOEs have their own issues. I am an ER Resident and while they are great in that they are both standardized and give everyone a blank slate, the interviewing student has no idea what is written in that SLOE. Many a good student has been blindsided by an unfair assessment and hears about it for the first time in an interview. Heavens forbid you make a mistake around the wrong attending who likes to talk to the clerkship director. At least with LORs you usually have an idea if there are any red flags to come your way.

David D, MD - USMLE and MCAT Tutor
Med School Tutors

 

[TheSingularity]

Step 1 is hugely important. Do not be fooled.

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[BorderlineQueen]

It depends on the specialty and what you want to go into. If you were gunning for derm and then get a step score of 210. Your chances of derm,ortho and other competitive specialties are slim to none. But with good SLOES and other things you can still match into a good program and good specialty that's not competitive.

 

[Matthew9Thirtyfive]

But its not like Step 1 alone will guarantee getting into those specialties, especially when everyone at that level has high Steps. That's why everything else matters. The Step 1 addicts usually just focus on Step 1 and ignore everything else.

Also school name can compensate a lot for Steps.

That’s not the point. All the other stuff in the world won’t get you matched if you get screened out at every program.

 

[longhaul3]

The most competitive specialties have median Step 1 scores for matched applicants around 250. There's a good amount of room above that. Applying in my specialty with a 245-250 won't get you any looks based on score alone, but if you're near 260 or above, it will always stand out (though, as OP said, not if you're from the Caribbean or are a criminal or something).

If you're a pre-med or are about to start med school and have interest in competitive specialties, know that Step 1 is critical.

 

[Lawpy]

That’s not the point. All the other stuff in the world won’t get you matched if you get screened out at every program.

Thats already stated in OP and few other posts. People keep viewing Steps and other stuff as something opposite that can't coexist when everything matters. That's the rationale behind Step 1 mania where people go all in on Step 1 and ignore everything else and have their clinical grades, letters etc deteriorate.

 

[Lawpy]

The most competitive specialties have median Step 1 scores for matched applicants around 250. There's a good amount of room above that. Applying in my specialty with a 245-250 won't get you any looks based on score alone, but if you're near 260 or above, it will always stand out (though, as OP said, not if you're from the Caribbean or are a criminal or something).

If you're a pre-med or are about to start med school and have interest in competitive specialties, know that Step 1 is critical.

This is true but to go further, high Step 1 + strong clinical grades + strong/productive research + strong letters + maybe school name >>> high Step 1 alone. That's really the key message behind OP and several other posts.

 

[Matthew9Thirtyfive]

Thats already stated in OP and few other posts. People keep viewing Steps and other stuff as something opposite that can't coexist when everything matters. That's the rationale behind Step 1 mania where people go all in on Step 1 and ignore everything else and have their clinical grades, letters etc deteriorate.

I mean are most people actually doing that? That’s not what I see at my school.

 

[CidHighwind]

I mean are most people actually doing that? That’s not what I see at my school.

Yeah, you still need to gun in med school the same way you did as a premed if you want AOA.

 

[Matthew9Thirtyfive]

Yeah, you still need to gun in med school the same way you did as a premed if you want AOA.

Yeah fortunately at my school we seem to have very few actual gunners, but most people are trying to do well in class, volunteer, get involved with stuff, etc.

 

[Angus Avagadro]

How important is personality (extroversion, sociability, etc) for letters of rec and evaluations? What if you’re decently smart and have a great work ethic but u kinda on the quieter side - is being quiet perceived negatively?

It hasn’t been an issue for me so far, I guess bc I’ve been lucky to have mentors/supervisors/professors that noticed my hard work despite the fact that I tend to keep my head down. Is it a different culture in medical school? Or does it just depend on the school/program/people you work with?

It doesnt hurt to be the quiet person who always knows the answer. One of my med school roomates, a year ahead of me, was #2 in his class and never would raise his hand to answer a question thrown out to the group of students. He always knew the answer when called on. His quiet nature changed over time. He is now, and has been a PD at a major university for many years. You can and will be recognized for being excellent even if you are quiet and shy. Good luck and best wishes!

 

[Lawpy]

I mean are most people actually doing that? That’s not what I see at my school.

OP thinks so

I see a lot of posts on here about how they’ll get into medical school and all they need is a high step 1 score and they’ll be fine. A high step score DOES NOT make up for a DUI. It does not make up for being a Caribbean grad. It does not make up for bad clinical grades, poor third year evaluations, bad letters of recommendation, poor interviewing, and no leadership or perceived commitment to the field.

Also apparently Step 1 content isn't closely related to answering pimp questions on clinical years but i'm not sure on this since it's what i got from N = small experiences.

Idk, i think everything builds up naturally so Step definitely deserves its importance. Idk how leadership and volunteering deserve its value since that can lead to burnout fast.

 

[Angus Avagadro]

I mean are most people actually doing that? That’s not what I see at my school.

I dont think it's anywhere near most, but certainly some do. I actually had a student admit to me that was their strategy. They said they were good at taking standardized tests. I implied it would take more than that to match well, but they were unconcerned. I hope it all works out for them.

 

[Matthew9Thirtyfive]

I dont think it's anywhere near most, but certainly some do. I actually had a student admit to me that was their strategy. They said they were good at taking standardized tests. I implied it would take more than that to match well, but they were unconcerned. I hope it all works out for them.

Yeah I mean I’m sure some people are but I hardly think it’s most either. I know every one in my class and only know a handful who are basically just ignoring everything and focusing on board prep material.

 

[longhaul3]

This is true but to go further, high Step 1 + strong clinical grades + strong/productive research + strong letters + maybe school name >>> high Step 1 alone. That's really the key message behind OP and several other posts.

I guess, but isn't that self-evident? I don't think downplaying the importance of Step 1 is wise. In the absence of unusual categorical disqualifiers, a high Step 1 score alone can get you interviews.

Where this is also underestimated is in mid-competitive specialties. In medicine or anesthesia or whatever, you can do nothing for all of med school and if you score 260, you're set up for success at some really good programs.

 

[Lawpy]

I guess, but isn't that self-evident? I don't think downplaying the importance of Step 1 is wise. In the absence of unusual categorical disqualifiers, a high Step 1 score alone can get you interviews.

Where this is also underestimated is in mid-competitive specialties. In medicine or anesthesia or whatever, you can do nothing for all of med school and if you score 260, you're set up for success at some really good programs.

Apparently it's not because there's this phenomenon on SDN where people can have high Step scores but royally mess up on clinical grades, letters and interviews. OP feels that way strong enough to make a thread about it.

I definitely agree Step 1 should be the main focus in preclinical years in traditional curricula, with research ideally being 2nd priority. Step 1 after clinical years gets tricky though since both matter a lot.

 

[Angus Avagadro]

I guess, but isn't that self-evident? I don't think downplaying the importance of Step 1 is wise. In the absence of unusual categorical disqualifiers, a high Step 1 score alone can get you interviews.

Where this is also underestimated is in mid-competitive specialties. In medicine or anesthesia or whatever, you can do nothing for all of med school and if you score 260, you're set up for success at some really good programs.

A 260 step 1 is around 94th%tile. Like a 515 or so Mcat. So if you think you can score in the top 4 % in the nation on pre clinical info, rock on. I dont think people are downplaying the importance of Step. It's like what @Goro says about pre meds. I'm paraphrasing, but they all think they are going to come into the game and sink a half court shot at the buzzer to win the game. If you dont hit that 260 amongst some rarified competition, you might be looking to match with average Step scores and grades. It's all about playing the match game well. I'm in agreement, it now starts with step scores, but it doesnt end there as many of our learned forum members have pointed out in the above posts.

 

[AnatomyGrey12]

I mean are most people actually doing that? That’s not what I see at my school.

I only know of 1 person who has done that. I'm pretty sure it get's thrown around a lot by people who rationalize why they have a lower Step score. The reality is that most people with high scores also have the rest of the package and are just elite applicants all around.

Also apparently Step 1 content isn't closely related to answering pimp questions on clinical years

This is a myth that get continually perpetuated. The people who know the answers to all the pimp questions attendings ask them are almost universally the people who scored highly. Step 1 is not made up of irrelevant information like many would like to pretend.

 

[Matthew9Thirtyfive]

I only know of 1 person who has done that. I'm pretty sure it get's thrown around a lot by people who rationalize why they have a lower Step score. The reality is that most people with high scores also have the rest of the package and are just elite applicants all around.


This is a myth that get continually perpetuated. The people who know the answers to all the pimp questions attendings ask them are almost universally the people who scored highly. Step 1 is not made up of irrelevant information like many would like to pretend.

Yeah I obviously haven’t taken step yet but I’ve definitely gotten questions right when asked by attendings because of things I’ve learned from FA/zanki. Friends have too.

 

[longhaul3]

Apparently it's not because there's this phenomenon on SDN where people can have high Step scores but royally mess up on clinical grades, letters and interviews. OP feels that way strong enough to make a thread about it.

I definitely agree Step 1 should be the main focus in preclinical years in traditional curricula, with research ideally being 2nd priority. Step 1 after clinical years gets tricky though since both matter a lot.

I took Step 1 after my core rotations and loved it. When you get 8-10 weeks to study I don't think it matters that you haven't seen the material for a year. The only significant drawback I see with it is that you don't know your score until you start 4th year, so if you have your heart set on a competitive specialty you just have to hope you do well.

A 260 step 1 is around 94th%tile. Like a 515 or so Mcat. So if you think you can score in the top 4 % in the nation on pre clinical info, rock on. I dont think people are downplaying the importance of Step. It's like what @Goro says about pre meds. I'm paraphrasing, but they all think they are going to come into the game and sink a half court shot at the buzzer to win the game. If you dont hit that 260 amongst some rarified competition, you might be looking to match with average Step scores and grades. It's all about playing the match game well. I'm in agreement, it now starts with step scores, but it doesnt end there as many of our learned forum members have pointed out in the above posts.

I think this is a better point than the initial premise of the thread. If you hit 260, you're well on your way to matching in almost any specialty. But like you say, planning on a 260 and doing it are two different things.

 

[Select All That Apply]

Whoever said a step 1 can't solve your problems.
Must not have scored a high enough step 1 to solve 'em.
~ jUsT kIdDiNg ~

 

[Lawpy]

This is a myth that get continually perpetuated. The people who know the answers to all the pimp questions attendings ask them are almost universally the people who scored highly. Step 1 is not made up of irrelevant information like many would like to pretend.

Well i'm confused:

Has Step I scoring changed?

I’m a private practice attending (dermatology) and I’m reading the medical student threads out of curiosity and seeing that quite a few things have changed. I was a med student in the 90s and back then MCAT scoring was a lot different. Your typical state school had an average MCAT of 28-29 or...

forums.studentdoctor.net

 

[efle]

I only know of 1 person who has done that. I'm pretty sure it get's thrown around a lot by people who rationalize why they have a lower Step score. The reality is that most people with high scores also have the rest of the package and are just elite applicants all around.


This is a myth that get continually perpetuated. The people who know the answers to all the pimp questions attendings ask them are almost universally the people who scored highly. Step 1 is not made up of irrelevant information like many would like to pretend.

We must have taken entirely different tests. It's 50% relevant at best. We had a ton of built-in teaching/pimping time on the Medicine service at the main hospital. Not once did anyone mention biochem pathways, interleukins or cell surface receptors or signal transduction pathways, chromosome locations or genetic mechanisms of any inherited diseases, any drug mechanisms/cellular targets, any path findings (e.g. psammoma bodies), any embryology whatsoever...I could go on for many more First Aid subsections.

Obviously a lot of what gets pimped is in Step1 and especially Step2 material, the argument against our current system has never been that they don't overlap. It's a Venn diagram for sure.

It's just one with a MOUNTAIN of unnecessary minutia to memorize in the "step 1 only" bubble.